Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Alice Koech, A-GNP-C

Individual provider Adult Health Nurse Practitioner · NPI 1669105656

Alice Koech, A-GNP-C is a Nurse Practitioner in Roseburg, Oregon. Qualified in 2022, 4 years ago. Practices with Intermountain Medical Group Grand Junction, LLC, a 299-clinician group and accepts Medicare assignment. Licensed in Oregon and Washington.

Years since qualifying
4
Licensed in
OR, WA
In the registry since
2022
Specialties on file
4
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Practice location Address checks out

1700 NW Garden Valley Blvd Ste 201
Roseburg, OR 97471-1636
Phone: (541) 464-0788
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 10000878 (OR)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence AP61327739 (WA)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence AP61327739 (WA)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence AP61327739 (WA)

Record details

NPI number1669105656
Entity typeIndividual (Type 1)
GenderFemale
Credentials A-GNP-C
Sole proprietorYes
NPI enumeratedJuly 6, 2022
Last updated in NPPESJanuary 9, 2023
Certification dateJanuary 9, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Intermountain Medical Group Grand Junction, Llc — 299 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Roseburg